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糖尿病酮症酸中毒的管理

Management of diabetic ketoacidosis.

作者信息

Donahey Elisabeth, Folse Stacey

机构信息

Emory University Hospital, 1364 Clifton Road, Atlanta, GA 30322, USA.

出版信息

Adv Emerg Nurs J. 2012 Jul-Sep;34(3):209-15. doi: 10.1097/TME.0b013e31826176f7.

Abstract

Diabetes, a chronic medical condition, continues to increase in prevalence. One of the most severe complications of diabetes, diabetic ketoacidosis (DKA), results from insulin deficiency and is a medical emergency that is frequently encountered in the emergency department. Prompt diagnosis, assessment of key laboratory values, appropriate treatment, and close monitoring are important to the successful treatment of this complex metabolic disorder. Fluid repletion and insulin administration are mainstays of DKA treatment and serve to restore normal hemodynamic status while decreasing the metabolic acidosis. Careful monitoring of glucose concentrations, vital signs, and electrolytes is essential to prevent complications arising from the treatment of DKA. This article provides an overview of the pathophysiology, presentation, diagnosis, treatment, monitoring, and complications of DKA.

摘要

糖尿病作为一种慢性疾病,其患病率持续上升。糖尿病最严重的并发症之一——糖尿病酮症酸中毒(DKA),是由胰岛素缺乏引起的,是急诊科经常遇到的医疗急症。及时诊断、评估关键实验室指标、适当治疗以及密切监测对于成功治疗这种复杂的代谢紊乱至关重要。补液和胰岛素治疗是DKA治疗的主要手段,有助于恢复正常的血流动力学状态,同时减轻代谢性酸中毒。仔细监测血糖浓度、生命体征和电解质对于预防DKA治疗引起的并发症至关重要。本文概述了DKA的病理生理学、临床表现、诊断、治疗、监测及并发症。

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